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Chan's balancing act

20th November 2006

11042006_who_report_square.jpgThe controversy between the World Health Organization (WHO) and the Chinese government over whether a new strain of bird flu has emerged epitomises current challenges facing the agency.

"The timing was ironic," writes David Dickson, Director of SciDev.Net. "Not only is the winning candidate, Margaret Chan, China's candidate for the post. But she owes her success partly to her commitment both to open communication and to her achievements firstly as the Department of Health's director in Hong Kong — where she led campaigns against SARS and bird flu — and more recently as head of the WHO's own efforts in this field."

It remains to be seen whether Chan can balance her public relations and political skills with sound science. She has already spoken of a need for evidence-based decision-making in health policy. Her emphasis on strategic interventions and new policy initiatives sits well with charitable efforts to support the practical side of developing healthcare in developing countries, he says.

But Dickson warns: "These initiatives, however, will only succeed if they are thoroughly grounded in sound scientific conclusions. If the WHO wants to influence government policy, it must take care that its arguments have a rigorous scientific basis, particularly when these are likely to be widely reported.

He calls for the agency to step up efforts to ensure that research results are applied in the field, and not just restricted to the laboratory, particularly in the case of the diseases of the poor, which hold little attraction for big pharmaceutical companies.

Hopefully Chan's stress on effective action will extend to active support for moves in the WHO to engage more deeply in the entire spectrum of health systems research, as recommended by the World Health Assembly. But without a significant increase in funding, which seems unlikely at the moment, there will be uncomfortable trade-offs to be made, he says.

He points out that Chan herself is aware of the need to take the broader context into account. "Not all of the problems faced by the WHO in its efforts to improve world health are subject to scientific scrutiny, or yield their secrets under a microscope," she said soon after her appointment. "Lack of resources and too little political commitment. These are often the true killers."

Chan's success will be measured by her ability to balance politics and science, he concludes.

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